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} <br /> '�E°�'e�` � �NSTRUCTION "��`� <br /> GTY OF �� <br />,' ���verett PE R M IT PERM�T No. _ 2 � � � � <br /> 259 -8810 <br /> ; rl DEMOUTION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER MAILADDPESS CITY 21P PHONE <br /> Bethanv of The Northwest 332 �aay Fverett 98201 259-SSoB <br /> TENANT MAILAOOPE55 CITY ZIP PMONE <br /> ARCMITELT OR UESIGNER MAIL V�ORE55 CITY 2iF PIIONE <br /> GENERALCONTHAC70R A1FIlA0DRES5 CITY ZIP PMONE LICENSE� <br /> C-Martin Truckina Inc. 20610 48th Ave W 1 nwood 98036 778-�106 (`MnuTm*�i7hNo <br /> MECHqNICALCONTflACTOR Mr11LAUDRE55 CITY ZIP PHONE LICENSEx <br /> P�UMeINGCONTPnCTOP MAD_AUDRESS LItY ZIP PHONE LICENSEM <br /> . CLASS OF WORK <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR h�l DEMOLITION ❑ BUILDING RELOCATION <br /> CONTACT PEflSON ANO PMONE NO.IF OTHER THAN OBOVE <br /> CONTRACT P(iICE OF WORK:$ <br /> DESCRIBE WORK AND SOUARE FOOTAfiE INVOIVED <br /> Demolish Bldg. I <br /> PROPOSE�USE OF DUILOING <br /> � LEGAL OESCRIPiION OF PROPERTV�SHOW DELOW OR ATTALH FOUR COPIEG� <br /> LOT- BLOCK-OF <br /> . See Attached - <br /> doe nooaess �'I <br /> � PLUMBING MECHANICAL �I� <br /> NO. TVPE OF FI%TURE OR ITEM FEE NO. TYPE OF EQUtPMENT FEE I <br /> , WATERCLOSET�TOILET) A/C—A/HNDLGUNITS—M.P. �_ I <br /> BATHTUB POflCED AIR SYSTEMS—B.T.U. M EA. �I <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> CLOTHES DRYERS '� '� ' ��� � <br /> SHOWER � <br /> . NITCHEN SINK 8 DISP. VENTILATION:AN ' <br /> DISHWASHER F7ANGE HCOD ` <br /> IAUNDRYTRAY WATER HEATER ' "4' � <br /> � CLOTHES WASHER WOOD STOVE " <br /> URINAL METAL PIREPLACE 8 CHIM y�n:4 ' Y '. <br /> � DRINKING FOUNTAIN FIREPLACE INSERT H � �'� �' i <br /> FIOOR DFAIN HEAT PUMP � � � � • �, <br /> BACKFLOW PREVENTERS GAS PIPING �� 4• ��' <br /> flOOFDRAINS—RAINLEADERS EXHAUSTFAN ' � �' ' <br /> t� S £1 . <br /> SINK(SEFVICE—BAR,ETC.) <br /> SUBTOTAL f SUBTOTAL S <br /> PENMIT f PERMIT S <br /> TOTAL FEE S TOTAL FEE S <br /> FRONTSETBnCK REARSETBncK 5iDE5ET9ACK PLANCHECKNUMBER FEE RECEIPTNO. <br /> USE20NE LOTAqEA VACANTSITE FEES BWIDINGC00[ FEE <br /> ❑ VES ❑NO <br /> IYPEOfCONSiPUCiIONALlOWA6lE iYPEOPCONSiPUCi10NACiUAI �qp� ��OOFDWEILING�NIiS BUILDING S <br /> PLUMBING <br /> SIZE OF BLDG. NO.OF STOFIES BASEMENT <br /> ❑VE^u ❑ NO MECHANICAL <br /> OCCU�ANCYLO�D FIRESPRINKLERSREO'D MEIGHTLIMITATION OTHER <br /> ❑VES ❑ NO <br /> REASONFORSPRINY.LEPS STATEBUILDINGSURCHARGE 4 50 ��, <br /> � STATEENERGVSUFCHAFGE I <br /> APPLICATIONACC.BY PLANSAPPROVED9V CITY OF EVERETT .� <br /> LOCAL SALES PUBLIC WORKS <br /> S.H. TAX CODE IS TOTAL 4 50 <br /> 3105 WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT <br /> PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN NDDRESS FILE 2 314 6 <br /> `� 180 DRYS OR CEASES FOR MORE THAN 180 DAYS. � <br />